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Ciccarone Articles

Ciccarone Center Research

Topic

Cardiac CT

Landmark Articles

Interplay of coronary artery calcification and traditional risk factors for the prediction of all-cause mortality in asymptomatic individuals.
By: Nasir K, Rubin J, Blaha MJ, Shaw LJ, Blankstein R, Rivera JJ, Khan AN, Berman D, Raggi P, Callister T, Rumberger JA, Min J, Jones SR, Blumenthal RS, Budoff MJ.
Current guidelines recommend the use of coronary artery calcification (CAC) scoring for intermediate risk patients; however, the potential role of CAC among individuals who have no risk factors is less established. We sought to examine the relationship between the presence and burden of traditional risk factors and CAC for the prediction of all-cause mortality. By highlighting that individuals without risk factors but elevated CAC have substantially higher event rates than those that have multiple risk factors but no CAC, these findings challenge the exclusive use of traditional risk assessment algorithms for guiding the intensity of primary prevention therapies.
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Coronary computed tomographic angiography and risk of all-cause mortality and nonfatal myocardial infarction in subjects without chest pain syndrome from the CONFIRM registry (Coronary CT Angiography Evaluation for Clinical Outcomes: An International...
By: Cho I, Chang HJ, Sung JM, Pencina MJ, Lin FY, Dunning AM, Achenbach S, Al-Mallah M, Berman DS, Budoff MJ, Callister TQ, Chow BJ, Delago A, Hadamitzky M, Hausleiter J, Maffei E, Cademartiri F, Kaufmann P, Shaw LJ, Raff GL, Chinnaiyan KM, Villines TC, Cheng V, Nasir K, Gomez M, Min JK; on behalf of the CONFIRM Investigators.

Although the prognosis for individuals without chest pain is stratified by coronary computed tomographic angiography (cCTA), the additional risk-predictive advantage by cCTA is not clinically meaningful compared with a risk model based on coronary artery calcium scoring. Therefore, at present, the application of cCTA for risk assessment of individuals without coronary artery calcium scoring should not be justified.

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Interplay of coronary artery calcification and traditional risk factors for the prediction of all-cause mortality in asymptomatic individuals.
By: Nasir K, Rubin J, Blaha MJ, Shaw LJ, Blankstein R, Rivera JJ, Khan A, Berman D, Raggi P, Callister T, Rumberger J, Min J, Jones SR, Blumenthal RS, Budoff MJ.
While both risk factors and CAC were associated with increasing CVD risk, CAC provides classification across a wider range of risk levels than traditional risk factors alone. Even among individuals with no risk factors, increased CAC is associated with a significantly higher CVD risk. While the absence of CAC is associated with very low intermediate term mortality, individuals with no risk factors but severe CAC have a high event rate.
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Low free testosterone in HIV-infected men is not associated with subclinical cardiovascular disease.
By: Monroe AK, Dobs AS, Xu X, Palella FJ, Kingsley LA, Post WS, Witt MD, Brown TT.

Low testosterone (T) is associated with cardiovascular disease (CVD) and increased mortality in the general population; however, the impact of T on subclinical CVD in HIV disease is unknown. This study examined the relationships among free testosterone (FT), subclinical CVD, and HIV disease. Compared with HIV-uninfected men, HIV-infected men had lower FT, as well as more prevalent carotid lesions. In both groups, FT was not associated with CAC presence, log carotid IMT, or carotid lesion presence, suggesting that FT does not influence subclinical CVD in this population of men with and at risk for HIV infection.

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Coronary artery calcium and primary prevention risk assessment: What is the evidence? An updated meta-analysis on patient and physician behavior.
By: Whelton SP, Nasir K, Blaha MJ, Gransar H, Metkus TS, Coresh J, Berman DS, Blumenthal RS.

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Vitamin D deficiency is associated with silent coronary artery disease in cardiovascularly asymptomatic African-Americans with HIV infection.
By: Lai H, Gerstenblith G, Fishman EK, Brinker J, Kickler T, Tong W, Bhatia S, Hong T, Chen S, Li J, Detrick B, Lai S.
Both vitamin D deficiency and silent CAD are prevalent in HIV-infected African-Americans. In addition to management of traditional CAD risk factors and substance abuse, vitamin D deficiency should be evaluated in HIV-infected African-Americans. These data support the conduct of a prospective trial of vitamin D in this high-risk patient population.
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Vitamin D deficiency is associated with the development of subclinical coronary artery disease in African-Americans with HIV infection: a preliminary study.
By: Lai H, Detrick B, Fishman EK, Gerstenblith G, Brinker JA, Hollis BW, Bartlett J, Cofrancesco J Jr, Tong W, Tai H, Chen S, Bhatia S, Lai S.
The incidence of subclinical CAD in African-Americans with HIV infection is provocatively high. Larger studies are warranted to confirm the role of vitamin D deficiency in the development of CAD in HIV-infected African-Americans.
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Comparative value of coronary artery calcium and multiple blood biomarkers for prognostication of cardiovascular events.
By: Rana JS, Gransar H, Wong ND, Shaw L, Pencina M, Nasir K, Rozanski A, Hayes SW, Thomson LE, Friedman JD, Min JK, Berman DS.
In this study of asymptomatic subjects without known CVD, the addition of CAC but not biomarkers substantially improved risk reclassification for future CVD events beyond traditional risk factors.
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C-reactive protein modifies the association of plasma leptin with coronary calcium in asymptomatic overweight individuals.
By: Martin SS, Qasim AN, Rader DJ, Reilly MP.

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Metabolic syndrome, diabetes, and incidence and progression of coronary calcium: the Multi-Ethnic Study of Atherosclerosis study.
By: Wong ND, Nelson JC, Granston T, Bertoni AG, Blumenthal RS, Carr JJ, Guerci A, Jacobs DR Jr, Kronmal R, Liu K, Saad M, Selvin E, Tracy R, Detrano R.
This study examines and compares the incidence and progression of CAC among persons with metabolic syndrome and diabetes mellitus (DM) versus those with neither condition. Individuals with metabolic syndrome and DM have a greater incidence and absolute progression of CAC compared with individuals without these conditions, with progression also predicting coronary heart disease events in those with metabolic syndrome and DM.
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